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动脉瘤形成和HIV相关血管病变的后卷复发:一个说明性的案例

Emmajane G Rhodenhiser¹, Christopher S Graffeo¹, Lea Scherschinski¹

¹Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.

Journal of neurosurgery. Case lessons

|March 3, 2025

概括

人类免疫缺陷病毒 (HIV) 相关的血管病变增加了动脉瘤风险. 由于复发风险,对于患有内动脉瘤的HIV阳性年轻患者,开放式外科切割可能是更好,而不是内血管治疗.

科学领域:

神经外科神经外科
血管神经学血管神经学
传染性疾病传染性疾病

背景情况:

艾滋病毒感染与独特的血管病变有关,增加了全身和内动脉瘤的风险.
内动脉瘤发生在高达14%的HIV阳性个体中,通常呈异常.
与艾滋病毒相关的血管病变有助于增加对动脉瘤形成和复发的易感性.

研究的目的:

在HIV阳性患者中报告一次复发性内动脉瘤的病例,该患者此前曾经接受内血管卷积治疗.
讨论艾滋病毒阳性个体中脑血管疾病的管理挑战和最佳治疗策略.

主要方法:

病例报告详细介绍了一个先前卷曲的中脑动脉动脉瘤复发在一个年轻的艾滋病毒阳性男性.
治疗涉及开放的微手术剪贴重建通过一个minipterional头骨切除和跨sylvian方法.
在手术期间的发现包括扩散性大脑dolichoectasia和复发性和de novo动脉瘤.

主要成果:

通过初级剪切成功地消除了复发的M2段和de novo A1段动脉瘤.
患者经历了良好的康复,在术后没有新的神经缺陷.
实现了完全动脉瘤消灭的放射性确认.

结论:

对患有脑血管疾病的HIV阳性患者进行的内血管治疗可能会有更高的失败率,需要密切监测.
开放的手术剪切可能有利于年轻的HIV阳性患者与内动脉瘤,当治疗选择是可比的.
长期监测对于HIV阳性的脑内动脉瘤患者来说至关重要,无论治疗方式如何.

关键词:

艾滋病病毒艾滋病病毒艾滋病病毒动脉瘤是一个动脉瘤.案例报告案例报告卷轴绕卷轴绕在线这是内血管内血管的内血管.人类免疫缺陷病毒人类免疫缺陷病毒微手术是一种微手术.复发性复发性复发性血管病变是一种血管病变.

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